Readmission in a Maternity Hospital for early mother-child relationship disorders

We report the original experience of admission in a post-delivery care unit, of a mother and her one-month-old child, for the treatment of post-delivery depression, in association with mother-child relational disorders. In this emergency situation, a maternity hospital team was involved in a maternity care.     

The psychotherapy relationship with borderline personality disorders.

Discusses different points of view concerning the psychotherapy relationship with borderline personality disorders from the standpoint of their possible effects on the process and outcome of psychotherapy. The following major positions are reviewed: (a) traditional psychoanalytic position of technical neutrality, (b) reality relationship in which the therapist shares thoughts and feelings with patients, and (c) establishment of a relationship to facilitate gratification of primitive developmental phases. It is proposed that the major position that theorists take in the psychotherapy relationship with borderline personality disorders, especially their handling of the developmental arrest and transference–countertransference issues, differentially affects the patients' personality structure within the context of separation–individuation. A case vignette of a 15-yr-old male is used to demonstrate this point. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Values: An issue in psychotherapy: Comments on a case study.

Discusses the treatment of a case of homosexual pedophilia by R. J. Kohlenberg (see PA, Vol 52:Issue 5), and the commentaries by G. C. Davison and G. T. Wilson and by H. H. Strupp (see PA, Vol 52:Issue 5), with special reference to the issue of values in psychotherapy. While the question of values is clearly involved in such matters as the acceptance of the client's goals, there appear to be differences in how these values are viewed or evaluated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A case study in a behavioral analysis of psychotherapy.

A content analysis guided by the points of view of psychoanalytic theory and learning theory was made of the verbalizations from the case history of a 24-year-old male. The content categories utilized were concerned with motivation and defense. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal constructs and psychodynamic psychotherapy: A case study.

[Correction Notice: An erratum for this article was reported in Vol 24(1) of Psychoanalytic Psychology (see record 2007-00135-015). An error was made in the reproduction of figures 5 and 6. The corrected versions are provided with the erratum.] During a short term, psychoanalytically informed psychotherapy, a college student's salient constructs regarding her self and her object representations were elicited via the Role Construct Repertory Test. The course of this psychotherapy is traced and is examined with regard to the information provided by component analyses of these repertory grids. The aims of this article are to demonstrate the utility of an independent measure such as repertory grids for 1) additional understanding of the patient's modes of construing self and others; 2) establishing meaningful foci for a short-term treatment; 3) providing information for a more considered set of interpretive interventions regarding key conflicts; and 4) considering changes and outcome in light of the foci of the treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between psychosis and epilepsy: a case study

This is a case study of a 49 year old spinster, with a history of temporal lobe epilepsy for more than 20 years. She was admitted to a psychiatric ward twice in one month, with two distinct types of psychoses, peri-ictal and inter-ictal psychosis. During peri-ictal psychoses, EEG tracing showed seizure activity, while a relatively normal EEG tracing was present during inter-ictal psychosis. The importance of a good clinical assessment to differentiate these two conditions is discussed.     

Brief psychotherapy for posttraumatic stress disorders.

A large-scale study of the effectiveness of psychotherapeutic methods for the treatment of posttraumatic stress disorders were conducted. The sample consisted of 112 persons suffering from serious disorders resulting from traumatic events (bereavement, acts of violence, and traffic accidents) that had taken place not more than 5 years before. Trauma desensitization, hypnotherapy, and psychodynamic therapy were tested for their effectiveness in comparison with a waiting-list control group. The results indicated that treated cases were significantly lower in trauma-related symptoms than the control group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group psychotherapy in a corrections facility: A case study of individual and institutional change.

Describes the transition from traditional group psychotherapy efforts to larger institutional social change in a corrections setting. The unique problems presented by the setting and the client population (15 prisoners at a low-security community corrections center) are recounted, as is the process of the group's attentional shift from intrapsychic concerns to increased individual responsibility and prisoner–guard relationships. Training clients to either change or avoid aversive influences in the corrections environment can be an appropriate and profitable focus for therapy. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early psychotherapy in posttraumatic syndromes. A case study

The present study analyses one case of posttraumatic syndrome following an accident, which was apparently benign. The author studies neuropsychological investigations and improvement during psychotherapy, along with intellectual "revalidation". The emotional perturbation is accompanied by a dysfunction in mental efficiency, mostly memory. The improvement takes place both in the affective and intellectual areas. The possible hypothesis regarding the etiology of such perturbations are being reviewed. The author underlines the impact of the emotional trauma along with the subsequent perturbations in a patient already sensitised to previous accidents in her family.     

Interpersonal complementarity and the therapeutic alliance: A study of relationship in psychotherapy.

Examined the relationship between the therapeutic alliance and interpersonal complementarity during the early stage of psychotherapy. 36 pairs of patients (aged 18–57 yrs) and therapists from 14 outpatient settings recorded their perceptions of their therapeutic alliance, using a working alliance inventory, and rated each other's therapy behaviors on the Checklist of Interpersonal Transactions. There were positive associations between patient–therapist interpersonal complementarity and both patients' and therapists' perceptions of the alliance. The more extreme/abnormal the patient's interpersonal behavior, the more both patient and therapist perceived a less positive working alliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A case study in communication disorders

Often, children with language disorders exhibit other more subtle delays or deviance in social, communicative, and cognitive development. By focusing on these three areas, the clinician can understand the developmental context in which the language delay manifests. This approach includes the following: gathering information, psychological and communicative examinations, psychiatric examination, and medical evaluation.     

Testimony psychotherapy in Bosnian refugees: a pilot study

OBJECTIVE: The authors sought to describe the use of the testimony method of psychotherapy in a group of traumatized adult refugees from genocide in Bosnia-Herzegovina. METHOD: The subjects were 20 Bosnian refugees in Chicago who gave written informed consent to participate in a case series study of testimony psychotherapy. All subjects received testimony psychotherapy, averaging six sessions, approximately 90 minutes, weekly or biweekly. Subjects received standardized instruments for posttraumatic stress disorder (PTSD), depression, traumatic events, global functioning, and prior psychiatric history. The instruments were administered before treatment, at the conclusion of the treatment, and at the 2- and 6-month follow-ups. RESULTS: The posttreatment assessments demonstrated significant decreases in the rate of PTSD diagnosis, PTSD symptom severity, and the severity of reexperiencing, avoidance, and hyperarousal symptom clusters. Depressive symptoms demonstrated a significant decrease, and there was a significant increase in scores on the Global Assessment of Functioning Scale. Two-month and 6-month follow-up assessments demonstrated further significant decreases in all symptoms and an increase in scores on the Global Assessment of Functioning Scale. CONCLUSIONS: This pilot study provides preliminary evidence that testimony psychotherapy may lead to improvements in PTSD and depressive symptoms, as well as to improvement of functioning, in survivors of state-sponsored violence.     

MDA-assisted psychotherapy with neurotic outpatients: a pilot study

Ten neurotic patients (five males and five females) were treated over a period of 2 to 6 months (mean, 4.1) as outpatients. The study allowed for a maximum of 75 hours of psychotherapy (mean, 51.55 hours). During the course of treatment, two to four (mean, 3.5) administrations of MDA (3,4-methylenedioxyamphetamine) were employed as adjunctive aids in an effort to enhance the psychotherapeutic process. The mean duration of the drug sessions was 8 hours (range, 6 to 14 hours). The first administration of MDA took place when, in the therapist's judgment, sufficient rapport had been established with the patient. All patients received an initial dose of 75 mg of MDA; subsequent dosage was allowed to range up to 200 mg. On these occasions, the drug appeared to be well tolerated with no serious side effects or complications observed. Psychometric assessments were obtained pre- and post-treatment, employing the Minnesota Multiphasic Personality Inventory (MMPI), Wittenborn Psychiatric Rating Scales (WPRS), and Brief Psychiatric Rating Scale (BPRS). In addition, follow-up evaluations were obtained 6 months after the termination of therapy by the use of the MMPI, WPRS, BPRS, and a Social History Questionnaire (SHQ) which had also been administered before treatment was initiated. Clinically, the impression was obtained that psychotherapy and the adjunctive use of MDA appeared to facilitate improvement in these patients. This impression was substantiated by significant reductions in scores on the psychometric assessments measuring depression, anxiety, and obsessive-compulsive traits. The meaures evaluating the sense of well-being and self-actualization also were encouraging. Although some of the patients were not as responsive as others, there were no observations to suggest that the condition of any of these patients had become worse.     

The relationship among patient contemplation, early alliance, and continuation in psychotherapy.

The present study examined the relationship among contemplation stage of readiness to change, formation of an early therapeutic alliance, and psychological distress following the first session of psychotherapy. Significant correlations between the contemplation scores and the therapeutic alliance were found for patients in the contemplation stage. Although contemplation scores were not a factor in return for a second session of psychotherapy, the bond subscale of the alliance inventory did significantly contribute to whether patients returned for therapy. Patient psychological distress was not a significant factor in predicting the early alliance. Results indicate a need for further focus on contemplation with its inherent ambivalence, its relationship to alliance, and continuation in early psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of core conflictual relationship themes before psychotherapy and during early sessions.

This report shows (a) that the Core Conflictual Relationship Theme (CCRT) can be rated reliably either from therapy sessions or from a special pretreatment interview in a group of depressed patients, and (b) that the CCRTs obtained before treatment are similar to the CCRTs extracted from the early sessions of brief dynamic psychotherapy. The data suggest that, at least in the early sessions of treatment, the therapist's influence did not significantly alter the patients' CCRTs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comment: Integrating methodologies in the scientific study of interpersonal psychotherapy: A reaction to Therapist immediacy in brief psychotherapy: Case study I and case study II.

In this reaction article, the author concentrates on selected methodological components characterizing both Kasper, Hill, and Kivlighan's (see record 2008-13167-001) and Hill, Sim, Spangler, Stahl, Sullivan, and Teyber's (see record 2008-13167-002) respective case studies of therapist immediacy in brief psychotherapy. In tandem, the foci and methodology of these investigations break new ground in the scientific study of interpersonal psychotherapy, and more generally they serve as paradigmatic illustrations of the form that psychotherapy research can take if it is to be truly more meaningful and useful for practitioners. Emphasis is placed on the investigators' integration of single-case research, elements of change process research, and quantitative and qualitative methods in a way that enables highly intensive examination of this core intervention in interpersonal psychotherapy. Specific elements and implications of each of these methodological components are briefly discussed, which also creates a context for addressing the issue of discovery versus verification as this pertains to the present studies. Some underlying philosophical considerations are also briefly touched on along the way. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The case for needs in psychotherapy.

In the history of psychology, proposals have been made regarding the nature of human needs, but this concept has yet to be incorporated into standard programs of intervention. I argue that unmet needs contribute to chronic psychological problems and, consequently, that a needs-based approach can be effective in their treatment. Situating needs in an ethological framework, I qualify six core needs that have emerged in the context of a psychotherapy practice that draws on both cognitive therapy and schema therapy. I outline a needs-based model that introduces a proactive dimension to these two approaches, and promotes flexible utilization of their respective clinical tools. The result is a more integrated and streamlined approach to the treatment of longer-term problems. I conclude by advocating the interdisciplinary study of needs as human adaptations. Clinicians of all orientations can play an important role in the development and application of a broadly based theory of needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypertensive disorders of pregnancy and maternal and foetal outcome: a case controlled study

A case controlled prospective study of 250 cases of hypertension complicating pregnancy (study group) and 400 normal pregnant women (control group) was carried out to determine the effect of hypertension on maternal and foetal outcome. Pregnancy induced hypertension was present in 96% cases and chronic hypertension in 4% cases. Preterm delivery (28.8% versus 3%), labour induction rate (52.8% versus 3.25%), caesarean section rate (14.8% versus 3.5%), stillbirth rate (4.8% versus 0.25%) and overall perinatal mortality rate (14.8% versus 1%) were higher in study group compared to controls. In study group (40%) babies required special nursery care compared to controls (6.75%). From these results it can be concluded that maternal hypertension is associated with adverse pregnancy outcome.     

Assessment of assimilation in psychotherapy: A quantitative case study of problematic experiences with a significant other.

The development of a methodology for the evaluation of the assimilation model in which both experimental rigor and clinical sensitivity are priorities is described. The methodology was applied to a good-outcome case. The 3-phase methodology comprised (1) the identification of a problematic content domain, (2) the definition of a problematic experience within that domain, and (3) the rating of the experience's changing level of assimilation across randomly ordered passages from selected sessions. Independent sets of raters carried out the tasks of each phase. Results supported the assimilation model's hypothesized progression by which a problematic experience is successfully incorporated into a schema, and the ratings highlighted 1 session in which much of the clinical progress on 1 problem was achieved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between upper gastrointestinal hemorrhage and drug use: a case control study

The relationship between upper gastrointestinal hemorrhage and drug use was studied in 251 Chinese patients (179 men, 72 women) admitted to the Prince of Wales Hospital, Hong Kong, and control subjects matched for age and sex. There was a highly significant difference between the cases and control subjects in the use of NSAIDs (odds ratio 14.0, p < 0.00001), ulcer healing drugs (odds ratio 12.5, p < 0.00001), and Chinese proprietary medicines (odds ratio 16.0, p < 0.00001). There was also a significant difference in the use of analgesics (odds ratio 14.0, p = 0.001), paracetamol (odds ratio 2.5, p = 0.01), antacids (odds ratio 2.7, p < 0.001) and unknown drugs (odds ratio 4.7, p < 0.001). Cases also differed from control subjects regarding the use of tobacco (odds ratio 2.3, p < 0.001) and alcohol (odds ratio 1.7, p = 0.02), and the presence of peptic ulcer symptoms (odds ratio 29.8, p < 0.00001). Significantly more control subjects than cases were receiving aspirin, cardiovascular drugs, bronchodilators, oral hypoglycemic drugs/lipid-lowering drugs, and anticonvulsants/hypnotics, due to the inevitable differences in disease pattern between the 2 groups. NSAID use was a major factor associated with upper gastrointestinal hemorrhage from primarily peptic ulcers. Differences in the use of other drugs may reflect variations in disease patterns between cases and controls, the common practice of self-medication in Hong Kong, and the concomitant use of NSAIDs and ulcer healing drugs/antacids.